Search PubMed⌕ Search

Biomedical subjects

R J Rosenberg

Publications and source records attributed to R J Rosenberg.

At least 19 recordsLinked to original sources
PubMed2000

Preoperative lymphoscintigraphy during lymphatic mapping for breast cancer: improved sentinel node imaging using subareolar injection of technetium 99m sulfur colloid.

BACKGROUND: Preoperative lymphoscintigraphy has been recommended to confirm the successful uptake and direction of migration of radiotracer into sentinel nodes during lymphatic mapping for breast cancer. In addition, preoperative lymphatic mapping may provide a visually useful aid to the relative location of sentinel nodes within a nodal basin. One common method of breast lymphoscintigraphy involves injections of unfiltered technetium 99m sulfur colloid (Tc-99m-SC) directly into parenchymal tissues surrounding a tumor or biopsy cavity (IP injection). Because of the many imaging failures and prolonged imaging times of IP lymphoscintigraphy, the procedure has fallen into disfavor by oncologic surgeons. The purpose of this study is to document the increased success rate of preoperative breast lymphoscintigraphy using a new anatomic site of injection, the subareolar lymphatic plexus (SA injection). STUDY DESIGN: In the 12 months between December 1, 1998, and December 29, 1999, 42 women with stage I and II breast cancer underwent preoperative lymphoscintigraphy by either the IP (n = 12, December 1998 to May 1999) or SA (n = 30, May 1999 to December 1999) route of injection. Both groups were injected with 1 mCi (37 MBq) of unfiltered Tc-99m-SC followed immediately by external gamma-camera imaging. The success rate for preoperative sentinel node imaging and the total imaging time were recorded in both groups. RESULTS: The success rate of identifying a sentinel node by SA lymphoscintigraphy was 90% (n = 27 of 30 patients), compared with 50% (n = 6 of 12 patients) for IP lymphoscintigraphy (p = 0.009). The imaging time in the SA injection group was 34 +/- 16 minutes, which was 59% shorter than the imaging time in the IP injection group of 82 +/- 48 minutes (p < 0.001). No uptake into internal mammary nodes was seen in either group. CONCLUSIONS: Moving the site of injection ofunfiltered Tc-99m-SC to the subareolar lymphatic plexus (SA injection) increased the success rate of preoperative lymphoscintigraphy to 90%, compared with 50% using IP injections. Preoperative SA lymphoscintigraphy resulted in the rapid visualization of axillary sentinel nodes within 30 minutes of SA injection, enabling a visual determination of the approximate number of sentinel nodes and their relative locations within the axilla. We conclude SA injection of unfiltered Tc-99m-SC is superior to IP injections when performing preoperative breast lymphoscintigraphy and is a visually useful aid to lymphatic mapping for breast cancer.

Adult↗
PubMed1999

Ureteral leak after renal transplantation.

In the course of radionuclide dynamic studies in 187 consecutive patients who had renal transplants, leakage from a ureter was identified in five cases (an incidence of less than 3%). Demonstrated patterns fell into three classes: 1) perirenal collection (n = 2), 2) peribladder activity (n = 2), and 3) downward dissection (n = 1 case). The sensitivity and specificity of the radionuclide study for detecting ureteral escape of urine after renal transplantation is unknown. However, this study suggests that both indices may be high.

Adult↗
PubMed1998

Coexistent parathyroid adenomas and Hurthle cell tumors: failure of full detection by subtraction method.

Tc-99m sestamibi and I-123 sodium iodide studies were performed on two patients, one with a neck mass and another with suspected hyperparathyroidism. Subtraction images, detected what proved to be Hurthle cell tumors in each case, but coexisting parathyroid adenomas, which were found at surgery, were not visualized. The findings indicate that both types of lesions can occur simultaneously, and that studies are needed to determine whether detailed assays of rate of washout could distinguish between the lesions.

Adenoma↗
PubMed1993

Splenic and partial hepatic necrosis after vascular occlusion.

A 74-year-old woman underwent two operations to correct an aortoduodenal fistula and to have an axillofemoral bypass graft inserted; these required temporary vascular occlusion. Her hepatic function test results began deteriorating. Initial and follow-up Tc-99m sulfur colloid studies revealed activity in the kidneys, consistent with disseminated intravascular coagulation. There was significant radiocolloid in the bone marrow and lungs, suggesting severe hepatic dysfunction. The spleen was not demonstrable on dynamic images or static views. In addition, there was a significant lateral hepatic defect, with a "lung overlap." The splenic lack of function and the hepatic lesion were due to necrosis (demonstrable on CT imaging), likely related to the prior vascular clamping.

Abdomen↗
PubMed1992

Endodontic case selection: to treat or to refer.

Endodontic treatment in the United States is delivered primarily by general dentists. A dilemma often arises as to which cases should be treated and which should be referred for specialty care. The case selection system described here rates endodontic cases so that practitioners can assess those cases they are best qualified to treat.

Anesthesia, Dental↗